Neutrophil Percentage-to-Albumin Ratio in the Diagnosis of Ovarian Torsion-Predictive Role

Background: Ovarian torsion is a medical emergency caused by ovarian rotation and requires prompt diagnosis and treatment to prevent complications such as ovarian necrosis. In our study, we aimed to predict ovarian torsion by evaluating preoperative neutrophil percentage-to-albumi...

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Main Authors: Rifat Sener, Sitki Ozbilgec, Fatih Akkus, Elif Ceyda Serin, Oguzhan Günenc
Format: Article
Language:English
Published: IMR Press 2025-04-01
Series:Clinical and Experimental Obstetrics & Gynecology
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Online Access:https://www.imrpress.com/journal/CEOG/52/4/10.31083/CEOG33516
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author Rifat Sener
Sitki Ozbilgec
Fatih Akkus
Elif Ceyda Serin
Oguzhan Günenc
author_facet Rifat Sener
Sitki Ozbilgec
Fatih Akkus
Elif Ceyda Serin
Oguzhan Günenc
author_sort Rifat Sener
collection DOAJ
description Background: Ovarian torsion is a medical emergency caused by ovarian rotation and requires prompt diagnosis and treatment to prevent complications such as ovarian necrosis. In our study, we aimed to predict ovarian torsion by evaluating preoperative neutrophil percentage-to-albumin ratio (NPAR) and inflammatory parameters among patients with ovarian cyst and ovarian torsion. Methods: This retrospective study includes 167 patients who underwent surgery for ovarian cysts or ovarian torsion between January 2021 and May 2024 at Konya City Hospital. Clinical characteristics, along with preoperative hematologic and inflammatory parameters, were compared between patients with and without torsion. Results: There was no significant difference in ovarian cyst size or cyst lateralization between the ovarian cyst and ovarian torsion groups (p = 0.595 and p = 0.932, respectively). Neutrophil percentage, neutrophil count, white blood cell (WBC) count, NPAR, and neutrophil-to-lymphocyte ratio (NLR) were higher in the ovarian torsion group (n = 83) compared to the ovarian cyst group (n = 84) (all p < 0.01). Lymphocyte count was lower in the ovarian torsion group. Although the systemic immune-inflammation index (SII) was higher in the torsion group, the difference was not statistically significant. A correlation analysis was performed between patient age, ovarian cyst size, and inflammatory parameters in the ovarian torsion group. When the NPAR cut-off was set at 1.66, high sensitivity (80.7%) and specificity (95.2%) were observed for ovarian torsion. The positive predictive value (PPV) was 94.3%, and the negative predictive value (NPV) was 83.3%. The area under the curve (AUC) for NPAR was 0.892 (95% confidence interval (CI): 0.837–0.947), indicating strong predictive performance (p = 0.001). Conclusions: The higher levels of NPAR, NLR, WBC count, neutrophil percentage, and neutrophil count observed in ovarian torsion cases suggest that these parameters may be useful in diagnosing ovarian torsion. In addition, the high sensitivity and specificity values of NPAR highlights its potential for future studies in the diagnosis of ovarian torsion.
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spelling doaj-art-41883cce3ca64481b70b90a13efa02322025-08-20T03:19:13ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632025-04-015243351610.31083/CEOG33516S0390-6663(25)02575-8Neutrophil Percentage-to-Albumin Ratio in the Diagnosis of Ovarian Torsion-Predictive RoleRifat Sener0Sitki Ozbilgec1Fatih Akkus2Elif Ceyda Serin3Oguzhan Günenc4Department of Gynecology and Obstetrics, Gynecological Oncology Surgery, Konya City Hospital, 42020 Konya, TürkiyeDepartment of Gynecology and Obstetrics, Gynecological Oncology Surgery, Konya City Hospital, 42020 Konya, TürkiyeDepartment of Obstetrics and Gynecology, Division of Perinatology, Necmettin Erbakan University Meram Faculty of Medicine, 42080 Konya, TürkiyeDepartment of Gynecology and Obstetrics, Konya City Hospital, 42020 Konya, TürkiyeDepartment of Gynecology and Obstetrics, Konya City Hospital, 42020 Konya, TürkiyeBackground: Ovarian torsion is a medical emergency caused by ovarian rotation and requires prompt diagnosis and treatment to prevent complications such as ovarian necrosis. In our study, we aimed to predict ovarian torsion by evaluating preoperative neutrophil percentage-to-albumin ratio (NPAR) and inflammatory parameters among patients with ovarian cyst and ovarian torsion. Methods: This retrospective study includes 167 patients who underwent surgery for ovarian cysts or ovarian torsion between January 2021 and May 2024 at Konya City Hospital. Clinical characteristics, along with preoperative hematologic and inflammatory parameters, were compared between patients with and without torsion. Results: There was no significant difference in ovarian cyst size or cyst lateralization between the ovarian cyst and ovarian torsion groups (p = 0.595 and p = 0.932, respectively). Neutrophil percentage, neutrophil count, white blood cell (WBC) count, NPAR, and neutrophil-to-lymphocyte ratio (NLR) were higher in the ovarian torsion group (n = 83) compared to the ovarian cyst group (n = 84) (all p < 0.01). Lymphocyte count was lower in the ovarian torsion group. Although the systemic immune-inflammation index (SII) was higher in the torsion group, the difference was not statistically significant. A correlation analysis was performed between patient age, ovarian cyst size, and inflammatory parameters in the ovarian torsion group. When the NPAR cut-off was set at 1.66, high sensitivity (80.7%) and specificity (95.2%) were observed for ovarian torsion. The positive predictive value (PPV) was 94.3%, and the negative predictive value (NPV) was 83.3%. The area under the curve (AUC) for NPAR was 0.892 (95% confidence interval (CI): 0.837–0.947), indicating strong predictive performance (p = 0.001). Conclusions: The higher levels of NPAR, NLR, WBC count, neutrophil percentage, and neutrophil count observed in ovarian torsion cases suggest that these parameters may be useful in diagnosing ovarian torsion. In addition, the high sensitivity and specificity values of NPAR highlights its potential for future studies in the diagnosis of ovarian torsion.https://www.imrpress.com/journal/CEOG/52/4/10.31083/CEOG33516ovarian torsionneutrophilsovarian cysts
spellingShingle Rifat Sener
Sitki Ozbilgec
Fatih Akkus
Elif Ceyda Serin
Oguzhan Günenc
Neutrophil Percentage-to-Albumin Ratio in the Diagnosis of Ovarian Torsion-Predictive Role
Clinical and Experimental Obstetrics & Gynecology
ovarian torsion
neutrophils
ovarian cysts
title Neutrophil Percentage-to-Albumin Ratio in the Diagnosis of Ovarian Torsion-Predictive Role
title_full Neutrophil Percentage-to-Albumin Ratio in the Diagnosis of Ovarian Torsion-Predictive Role
title_fullStr Neutrophil Percentage-to-Albumin Ratio in the Diagnosis of Ovarian Torsion-Predictive Role
title_full_unstemmed Neutrophil Percentage-to-Albumin Ratio in the Diagnosis of Ovarian Torsion-Predictive Role
title_short Neutrophil Percentage-to-Albumin Ratio in the Diagnosis of Ovarian Torsion-Predictive Role
title_sort neutrophil percentage to albumin ratio in the diagnosis of ovarian torsion predictive role
topic ovarian torsion
neutrophils
ovarian cysts
url https://www.imrpress.com/journal/CEOG/52/4/10.31083/CEOG33516
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AT fatihakkus neutrophilpercentagetoalbuminratiointhediagnosisofovariantorsionpredictiverole
AT elifceydaserin neutrophilpercentagetoalbuminratiointhediagnosisofovariantorsionpredictiverole
AT oguzhangunenc neutrophilpercentagetoalbuminratiointhediagnosisofovariantorsionpredictiverole